Individual provider Active NPI

Anem Javed Nawaz

  • Psychiatry Physician
  • Jacksonville Beach, FL
National Provider Identifier
1356831267
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME152664 Issued in FL
Practice address
1300 Marsh Landing Pkwy Ste 112
Jacksonville Beach, FL 32250-2407
Phone
(904) 456-0002
NPI assigned
May 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X ME152664 FL Primary

Addresses

Primary practice location

1300 Marsh Landing Pkwy Ste 112
Jacksonville Beach, FL 32250-2407

Mailing address

1300 Marsh Landing Pkwy Ste 112
Jacksonville Beach, FL 32250-2407
Phone (904) 456-0002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221117000139 FL Practitioner - Psychiatry 8820341373 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optum Behavioral Care of North Carolina PCGroup PAC ID 5092120030, 175 clinicians

Practice addresses (Care Compare)

1090 S Tamiami TRL
Sarasota, FL 34236-9116
Phone (941) 363-0878

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME152664FLMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of North Carolina, P.C. CurrentSince Feb 15, 2024 Accepting new patients
Optum Behavioral Care of North Carolina, PC CurrentSince Feb 15, 2024 Accepting new patients

Locations

1300 Marsh Landing Pkwy
Ste 112
Jacksonville Beach, FL 32250
Phone (904) 456-0002

1090 Tamiami Trl
Sarasota, FL 34236
Phone 94136308782005

Interoperability endpoints

  • Direct secure messaging: anem.nawaz@hca5.eclinicaldirectplus.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1526428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1356831267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 MARSH LANDING PKWY STE 112",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322502407",
            "telephone_number": "904-456-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MARSH LANDING PKWY STE 112",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322502407",
            "telephone_number": "904-456-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAWAZ",
        "first_name": "ANEM",
        "middle_name": "JAVED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-16",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME152664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville Beach, FL

Sources for this page

Verify at the official NPI Registry.